华法林治疗川崎病合并巨大冠状动脉瘤安全性及有效性分析

目的：探讨粉尘螨滴剂舌下免疫治疗（SLIT）对尘螨过敏儿童咳嗽变异型哮喘（CVA）的临床疗效。方法：选取2017年1月至2019年1月我院328例确诊为粉尘螨过敏诱发CVA患儿,排除随访脱落及不配合治疗患儿,最终纳入275例,随机分为对照组（n=132）和观察组（n=143）。对照组给予丙酸氟替卡松气雾剂吸入及孟鲁司特钠咀嚼片口服治疗,观察组在对照组治疗基础上给予粉尘螨滴剂治疗,每6个月随访1次,随访时间12个月,比较两组日/夜间咳嗽症状评分、肺功能、辅助性T细胞17（Th17）和调节性T细胞（Treg细胞）比例、血清白介素10（IL-10）和IL-17水平变化情况。结果：治疗前,两组日/夜间咳嗽症状评分、肺功能、Th17和Treg细胞比例、血清IL-10和IL-17水平比较差异无统计学意义（P均>0.05）;治疗后,两组日/夜间咳嗽症状评分、肺功能、Th17和Treg细胞比例、血清IL-10和IL-17水平比较差异有统计学意义（P均<0.05）。两组Th17细胞比例和血清IL-17水平较治疗前下降,两组Treg细胞比例和血清IL-10水平较治疗前升高（P均<0.05）。结论：粉尘螨滴剂舌下免疫治疗可有效改善尘螨过敏CVA患儿临床症状,其主要机制可能是通过改变Th17/Treg细胞水平进而调节机体免疫平衡。     

昆明市青少年变应性鼻炎患者变应原谱分析

目的调查昆明地区变应性鼻炎（allergicrhinitis,AR）患者的变应原谱。方法将具有典型AR临床症状的567例患者按年龄分为9组,采用13种当地常见变应原对不同性别年龄组患者进行变应原分布情况分析。结果①女性患者粉尘螨、户尘螨、蒿属花粉和法国梧桐的过敏阳性率显著高于男性（t=2．701,P=0．012）。②不同年龄组中,过敏原分布比较差异无统计学意义（P〉0．05）。③93．5％患者检测出过敏原,其中2．1％患者对一种过敏原过敏,91．4％患者为多重过敏。在粉尘螨与户尘螨两种过敏原中,5．46％仅对其中一种尘螨过敏,85．4％同时对两种尘螨过敏。④平均过敏原的个数随年龄增大而增多（F=8．738,P=0．012）,而各年龄组男女性别间比较差异无统计学意义（F=1．873,P=0．400）。结论尘螨、蒿属花粉和法国梧桐是昆明地区最常见的过敏原,随年龄增长,患者的人均变应原个数增多。     

粉尘螨滴剂简化疗法治疗小儿哮喘的临床研究

目的探讨粉尘螨滴剂简化疗法治疗小儿哮喘的临床疗效及安全性。方法采用随机数字表法将100例支气管哮喘患儿随机分为治疗组（n=50例）和对照组（n=50例）,治疗组采用简化的粉尘螨滴剂舌下治疗,而对照组采用传统的粉尘螨滴剂舌下治疗,观察期为1年。结果治疗组的治疗有效率为90．0％,与对照组的94．0％比较无统计学差异（P〉0．05）;治疗组的肺功能指标（FEVl、PEF、V25％～75％）、观察指标（sIgE、slgG、血EOS、痰EOS）、不良反应等方面与对照组比较均无统计学差异（P〉0．05）。结论粉尘螨滴剂简化疗法治疗小儿哮喘基本等效于传统治疗方法,具有安全性好、副作用少、服用方便、依从性强及便于用药等特点。     

畅迪治疗小儿异位性皮炎疗效观察及其对血清因子水平的影响

目的 检测异位性皮炎患儿血清中IL-4、IFN-γ水平变化,探讨Thl与Th2的平衡与异位性皮炎之间的关系及畅迪对血清因子的影响.方法 采用ELISA法检测30例健康小儿和采用粉尘螨滴剂治疗前后的30例异位性皮炎患儿血清中IL-4,IFN-γ水平,并观察药物的临床疗效.结果 患儿治疗前血清中IL-4浓度(98.64±2...     

Sensitization to aeroallergens in Korean children: a population-based study in 2010

We performed this study to assess the prevalence of sensitization to aeroallergens and to analyze the difference between prevalence rates according to children's ages and residential areas. In this nationwide cross-sectional study, first grade students of 45 elementary schools and 40 middle schools were randomly selected, and skin prick tests were performed for 18 inhalant allergens between October and November 2010. Of 7,829 analyzed subjects, 3,753 (47.9%) were sensitized to at least one aeroallergen. Sensitization to Dermatophagoides farinae was found to be the most prevalent in elementary schoolchildren (32.4%), followed by Dermatophagoides pteronyssinus, Tyrophagus putrescentiae, Japanese hop, and oak. In middle schoolchildren, D. pteronyssinus yielded the highest prevalence (42.7%), followed by D. farinae, T. putrescentiae, Japanese hop, and cat. In middle schoolchildren, the sensitization rate to aeroallergens in metropolitan, urban, and rural areas was 57.2%, 54.3%, and 49.8%, respectively (P = 0.019). In this age group, the sensitization rate in low, middle, high, and very high income groups was 53.8%, 51.8%, 59.0%, and 59.6%, respectively (P = 0.002). In conclusion, the sensitization rate is 47.9% and house dust mite is the most prevalent allergen in the pediatric population in Korea. The rate is higher in metropolitan areas and the highest income group than in rural areas and low income groups.     

Sequence analysis and expression of a cDNA clone encoding a 98-kDa allergen in Dermatophagoides farinae

BACKGROUND: The important dust mite allergens identified to date are of molecular weights ranging from 14 to 60 kDa. Our previous protein study indicated that the 98-kDa native paramyosin in Dermatophagoides farinae mite showed IgE reactivity with 82% of the mite-sensitive asthmatic patients suggesting that it is a novel major mite allergen. This study described the isolation and characterization of the cDNA clone encoding the 98-kDa mite allergen. METHODS: A Dermatophagoides farinae cDNA library was constructed in lambda ZAPII vector and the library was immunoscreened with a monoclonal antibody 642. The cDNA insert was sub-cloned into M13 sequencing vector for single-stranded sequencing. The whole cDNA insert was expressed in pGEX-2T Escherichia coli expression system as a fusion protein with GST. The allergenicity of the recombinant peptides was tested by skin tests and IgE immunoassay. The IgE and IgG immunoassays were performed with sera from 20 mite-allergic patients. RESULTS: The cDNA clone Df642 was 2134 bp long, coding for a polypeptide of 711 amino acid residues. Protein sequence analysis and alignment confirmed that the deduced polypeptide is a mite paramyosin which is truncated slightly at the N- and C-terminuses. In vivo skin tests and in vitro IgE-binding study showed that 62% (13/21) and 50% (10/20) of the mite-sensitive asthmatic patients reacted positively with the recombinant Dermatophagoides farinae paramyosin, respectively. CONCLUSION: The study indicated that 98-kDa mite paramyosin is an important allergen.     

粉尘螨变应原第5组分基因克隆及分子特征分析

目的 获得粉尘螨变应原第5组分的编码基因(Der f5)并了解其分子特征.方法 用RNAiso试剂盒提取粉尘螨总RNA,根据GenBank已公布的Der f5核酸序列设计引物,用RT-PCR扩增获得其编码基因,插入pMD19-T Simple载体进行序列测定和分析.结果 获得的Der f5基因与参考序列(GenBank AY283283)同源性达97.8%,含1个完整的开放阅读框架(ORF),由132个氨基酸组成,信号肽位于1～19AA、跨膜区域位于1～19AA,为细胞外疏水性蛋白.二级结构由延伸主链(1.52%)、无规则卷曲(7.58%)和α螺旋(90.91%)组成.具有酪蛋白激酶Ⅱ磷酸化位点2个.其氨基酸序列与屋尘螨变应原第5组分相似率为78%.结论 成功克隆了 Der f5,并初步预测得其分子特征.     

Inflammatory and remodeling events in asthma with chronic exposure to house dust mites: a murine model

Although animal models with ovalbumin have been used to study chronic asthma, there are difficulties in inducing recurrence as well as in maintaining chronic inflammation in this system. Using a murine model of house dust mite (HDM)-induced bronchial asthma, we examined the airway remodeling process in response to the chronic exposure to HDM. During the seventh and twelfth weeks of study, HDM were inhaled through the nose for three consecutive days and airway responsiveness was measured. Twenty-four hours later, bronchoalveolar lavage and histological examination were performed. The degree of overproduction of mucus, subepithelial fibrosis, and the thickness of the peribronchial smooth muscle in the experimental group was clearly increased compared to the control group. In addition, HDM-exposed mice demonstrated severe airway hyperreactivity to methacholine. In the bronchoalveolar lavage fluid, the number of total cells and eosinophils was increased; during the twelfth week, the number of neutrophils increased in the experimental group. With regard to changes in cytokines, the concentrations of IL-4, IL- 13, and transforming growth factor-beta (TGF-beta) were increased in the experimental group. The data suggest that eosinophils, IL-4, IL-13, and TGF-beta might play an important role in the airway remodeling process and that neutrophils may be involved with increased exposure time.     

变应性鼻炎舌下免疫治疗的疗效及安全性评价

目的 研究标准化粉尘螨滴剂舌下免疫治疗变应性鼻炎的疗效及安全性.方法 87例尘螨过敏为主的变应性鼻炎患者随机分为舌下免疫治疗(sublingual immunotherapy,SLIT)+药物组和药物治疗组.SLIT+药物组以标准化粉尘螨滴剂舌下含服免疫治疗,辅以对症药物治疗;药物治疗组以氯雷他定片及丙酸氟替卡松鼻喷剂...